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CODE: 1091
 

PLEURAL EFFUSION IN BODIES RECOVERED FROM WATER

 

 

Yorulmaz C, Arican N, Afacan I, Dokgoz H, Asirdizer M.

 

Forensic Sciences International, 2003; 136: 16-21.

 

 

ABSTRACT

 

Both in saltwater and freshwater drowning cases, a common autopsy sign is pleural effusion. However, the factors that determine the amount of pleural effusion have not been well established. An attempt was therefore made to correlate the amount of pleural fluid in bodies recovered from water with several parameters registered on the judicial files as well as autopsy findings from the years 1994–1998. The number of cases with pleural fluid increase was found to be very high in saltwater drowning (P <0 001). But, when the freshwater and saltwater drowning cases with pleural fluid increase were compared according to pleural fluid amount, no significant difference was detected (521 ± 340 and 768 ± 536 ml, respectively). Although there was a positive correlation between the decomposition degree and the fluid in the pleural cavity, a relative decrease was detected in the amount of effusion contrary to the expectations in cases of extreme decomposition. Pleural fluid amount provides significant data about the type of water and the cause of death in early postmortem interval. And there is a link between the time spent in water and the amount of pleural effusion. With the advance of the postmortem interval, decomposition level and the duration of immersion should be taken into account in differential diagnosis.

 

Key words: Drowning; pleural effusion; decomposition.

CITED BY:

1. Lunetta P, Model JH, Sajantila A. “What is the incidence and significance of dry-lungs in bodies found in water?” The American Journal of Forensic Medicine and Pathology.2004; 25(4): 291-301.

2. Hochrein MJ. “A bibliography related to crime scene interpretation with emphases in forensic geotaphonomic and forensic archaeological field techniques (eleventh edition)”. United States Department of Justice, Federal Bureau of Investigation, FBI Print Shop, Washington, D.C. 2004.

3. Inoue H, Ishida T, Tsuji A, Kudo K, Ikeda N. “Electrolyte analysis in pleural effusion as an indicator of the drowning medium”, Legal Medicine 2005; 7(2):  96–102

4. Lunetta P, Modell JH. “Macroscopical, microscopical, and laboratory findings in drowning victims” in Forensic Pathology Reviews, Vol: 3 (Ed: Tsakos M). Humana Press, Totowa, 2005; pp: 3-77.

5. Nishitani Y, Fujii K, Okazaki S, Imabayashi K, Matsumoto H. “Weight ratio of the lungs and pleural effusion to the spleen in the diagnosis of drowning”, Legal Medicine 2006; 8(1): 22-27.

6. Somers GR, Chiasson DA, Smith CR. “Pediatric drowning: a 20-year review of autopsied cases: II. pathologic features”, The American Journal of Forensic Medicine and Pathology. 2006; 27(1): 20-24. 

7. Somers GR, Chiasson DA, Smith CR. “Pediatric drowning: a 20- year review of autopsied cases: III. bathtub drownings”, The American Journal of Forensic Medicine and Pathology. 2006, 27(2): 113-6.

8. Piette MH, De Letter EA. “ Drowning: still a difficult autopsy diagnosis”, Forensic Sci Int. 2006: 163 (1-2): 1-9.

9. Zhihai H, Light F, Yonyou D. “The sea flooding drowns sends the research progress and the forecast which the acute lung damages”, Chinese Navigation Medicine and High Pressure Medicine Magazine. 2006; 13(6): 378-381.

10. Azparren JE, Cubero C, Perucha E, Martinez P, Vallejo G. “Comparison between lung weight and blood strontium in bodies found in seawater”, Forensic Sci Int. 2007; 168 (2-3): 128-32.

11. Shkrum MJ, Ramsay DA. “Bodies recovered from water” in Forensic Science and Medicine, Common Problems for the Pathologist.  Humana Press, Totowa, 2007; pp: 260.

12. Palanco JLR. “Muertes por sumersión - revisión y actualización de un tema clásico de la medicina forense [Deaths by drowning - a classic topic in Forensic Medicine revisited]”, Cuad Med Forense 2007; 13(48-49):99-130.

13. Oh JB, Cha EJ, Park JW, Chung IJ, Kim YS, Lee HY, Lee H.  A study of weight ratio of lung to the spleen for the diagnostic index of drowning [익사의 지표로서 /비장 무게의 비율에 대한 연구 (KOREAN)]. Kor J Legal Med. 2007; 31(1): 72-77.

14. Somers GR, Chiasson DA, Taylor GP. “Presence of periorbital and conjunctival petechial hemorrhages in accidental pediatric drowning”, Forensic Science International, 2008; 175 (2-3): 198-201.

15. Zhihai H, Yonyou D, Yuhong L, Huasong F, Zhicheng Z, Tao G, Dapeng W. "Establishment of acute lung injury model induced by seawater drowning in rabbits". Journal of Naval General Hospital, PLA. 2007; 20 (3): 132-5.

16. Beauthier JP, Ramsay DA. Traité de médecine légale” De Boeck Université Press, Bruxelles, 2008; pp: 260.

17. Usumato Y, Sameshima N, Hikiji W, Tsuji A, Kudo K. Inoue H, Ikeda N. Electrolyte analysis of pleural effusion as an indicator of drowning in seawater and freshwater. J Forensic Leg Med. 2009, 16(6): 321-4.

18. Canturk N, Canturk G, Karbeyaz K, Ozdes T, Dagalp R, Celik S.."Ankara’da 2003-2006 yılları arasında otopsisi yapılan suda boğulma olgularının değerlendirilmesi". Turkiye Klinikleri J Med Sci. 2009; 29(5): 1198-205.

19. Papadodima SA, Athanaselis SA, Skliros E, Spiliopoulou CA. "Forensic investigation of submersion deaths. Int J Clin Pract. 2010; 64(1): 75-83. 

20. An JL, Ishida Y, Kimura A, Kondo T. "Forensic application of intrarenal aquaporin-2 expression for differential diagnosis between freshwater and saltwater drowning". Int J Legal Med. 2010 Mar; 124(2): 99-104.

21. Heaton V, Lagden A, Moffatt C, Simmons T. Predicting the postmortem submersion interval for human remains recovered from U.K. waterways*. J Forensic Sci. 2010 Mar; 55(2): 302-7.

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